Despite being one of the most common injuries around the elbow, the optimal treatment of olecranon
Aims. Periprosthetic
Aims. Management of displaced paediatric supracondylar elbow
Aims. The aim of this study was to describe the demographic details of patients who sustain a femoral periprosthetic
Aims. To report the outcomes of patients with a
Aims. The aim of this study was to describe the management and associated outcomes of patients sustaining a femoral hip periprosthetic
In the UK, multidisciplinary teamwork for patients with hip
Aims. The aims of this study were to report the outcomes of patients with a complex
Aims. The aim of this study was to compare the cost-effectiveness of surgical fixation with Kirschner (K-)wire ersus moulded casting after manipulation of a
Aims. Periprosthetic femoral fracture (PPF) is a major complication following total hip arthroplasty (THA). Uncemented femoral components are widely preferred in primary THA, but are associated with higher PPF risk than cemented components. Collared components have reduced PPF rates following uncemented primary THA compared to collarless components, while maintaining similar prosthetic designs. The purpose of this study was to analyze PPF rate between collarless and collared component designs in a consecutive cohort of posterior approach THAs performed by two high-volume surgeons. Methods. This retrospective series included 1,888 uncemented primary THAs using the posterior approach performed by two surgeons (PKS, JMV) from January 2016 to December 2022. Both surgeons switched from collarless to collared components in mid-2020, which was the only change in surgical practice. Data related to component design, PPF rate, and requirement for revision surgery were collected. A total of 1,123 patients (59.5%) received a collarless femoral component and 765 (40.5%) received a collared component. PPFs were identified using medical records and radiological imaging.
Aims. This study aimed to compare the outcomes of two different postoperative management approaches following surgical fixation of ankle
Aims. The aim of this trial was to assess the cost-effectiveness of a soft bandage and immediate discharge, compared with rigid immobilization, in children aged four to 15 years with a torus
Aims. The aim of this study was to explore current use of the Global Fragility
Aims. The primary aim of this study was to address the hypothesis that
Aims. This study evaluated variation in the surgical treatment of stable (A1) and unstable (A2) trochanteric hip
Aims. The aim of this study is to develop a core set of outcome domains that should be considered and reported in all future trials of childhood limb
Aims. The aim of this study was to determine the current incidence and epidemiology of humeral diaphyseal
Aims. Osseointegrated prosthetic limbs allow better mobility than socket-mounted prosthetics for lower limb amputees. Fractures, however, can occur in the residual limb, but they have rarely been reported. Approximately 2% to 3% of amputees with socket-mounted prostheses may
Aims. The aim of this study was to identify modifiable risk factors associated with mortality in patients requiring revision total hip arthroplasty (THA) for periprosthetic hip
Aims.
Aims. This study evaluates the quality of patient-reported outcome measures (PROMs) reported in childhood
Aims. The primary aim of this study was to develop a reliable, effective radiological score to assess the healing of humeral shaft
Ceramic bearings have several desirable properties, such as resistance to wear, hardness, and biocompatibility, that favour it as an articulating surface in hip arthroplasty. However, ceramic
Aims. The aim of this study was to utilize a national paediatric inpatient database to determine whether obesity influences the operative management and inpatient outcomes of paediatric limb
Aims. The aim of this study was to investigate the difference in functional outcome after repair and non-repair of the pronator quadratus muscle in patients undergoing surgical treatment for a distal radial
Aims. Although infrequent, a
Aims. We reviewed all patients who sustained a
Aims. The aim of this study was to report the outcome following primary
fixation or a staged protocol for type C
Aims. Rates of mortality as high as 25% to 30% have been described
following
Aims. To evaluate whether an ultra-low-dose CT protocol can diagnose
selected limb
Aims. To evaluate interobserver reliability of the Orthopaedic Trauma
Association’s open
Fractures of the odontoid peg are common spinal
injuries in the elderly. This study compares the survivorship of
a cohort of elderly patients with an isolated
We present the prevalence of multiple fractures
in the elderly in a single catchment population of 780 000 treated over
a 12-month period and describe the mechanisms of injury, common
patterns of occurrence, management, and the associated mortality
rate. A total of 2335 patients, aged ≥ 65 years of age, were prospectively
assessed and of these 119 patients (5.1%) presented with multiple
fractures. Distal radial (odds ratio (OR) 5.1, p <
0.0001), proximal humeral
(OR 2.2, p <
0.0001) and pelvic (OR 4.9, p <
0.0001) fractures
were associated with an increased risk of sustaining associated
fractures. Only 4.5% of patients sustained multiple
Bicondylar tibial plateau
Aims. The aim of this prospective randomised controlled trial was to
compare non-operative and operative management for acute isolated
displaced
The aim of this study was to report the pattern
of severe open diaphyseal tibial
Since the Oxford knee was first used unicompartmentally
in 1982, a small number of bearings have
Aims. The purpose of this study was to compare symptomatic treatment
of a
In this study, we describe a morphological classification
for greater tuberosity
The Nottingham Hip
Fractures of the hip are common, often occurring
in frail elderly patients, but also in younger fit healthy patients following
trauma. They have a significant associated mortality and major social
and financial implications to patients and health care providers.
Many guidelines are available for the management of these patients,
mostly recommending early surgery for the best outcomes. As a result,
healthcare authorities now put pressure on surgical teams to ‘fast
track’ patients with a
Aims. In approximately 20% of patients with ankle
Aims. The fundamental concept of open reduction and internal fixation
(ORIF) of ankle
We define the long-term outcomes and rates of
further operative intervention following displaced Bennett’s fractures
treated with Kirschner (K-) wire fixation between 1996 and 2009.
We retrospectively identified 143 patients (127 men and 16 women)
with a mean age at the time of injury of 33.2 years (18 to 75).
Electronic records were examined and patients were invited to complete
the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire
in addition to a satisfaction questionnaire. The time since injury
was a mean of 11.5 years (3.4 to 18.5). In total 11 patients had
died, one had developed dementia and 12 patients were lost to follow-up.
This left 119 patients available for recruitment. Of these, 57 did
not respond, leaving a study group of 62 patients. Patients reported
excellent functional outcomes and high levels of satisfaction at
follow-up. Median satisfaction was 94% (interquartile range 91.5
to 97.5) and the mean DASH score was 3.0 (0 to 38). None of the patients
had undergone salvage procedures and none of the responders had
changed occupation or sporting activities. Long-term patient reported
outcomes following displaced Bennett’s
In light of the growing number of elderly osteopenic
patients with distal humeral
The role of arthroscopy in the treatment of soft-tissue
injuries associated with proximal tibial
We compared the clinical and radiological outcomes
of two cementless femoral stems in the treatment of patients with
a Garden III or IV
We performed a case–control study to compare
the rates of further surgery, revision and complications, operating time
and survival in patients who were treated with either an uncemented
hydroxyapatite-coated Corail bipolar femoral stem or a cemented
Exeter stem for a displaced intracapsular
We undertook a randomised controlled trial to
compare bipolar hemiarthroplasty (HA) with a novel total hip replacement
(THR) comprising a polycarbonate–urethane (PCU) acetabular component
coupled with a large-diameter metal femoral head for the treatment
of displaced
Aims. Paediatric triplane
There are no recent studies comparing cable with
wire for the fixation of osteotomies or
The aims of this study were to assess the efficacy
of a newly designed radiological technique (the radial groove view)
for the detection of protrusion of screws in the groove for the
extensor pollicis longus tendon (EPL) during plating of distal radial
fractures. We also aimed to determine the optimum position of the
forearm to obtain this view. We initially analysed the anatomy of
the EPL groove by performing three-dimensional CT on 51 normal forearms.
The mean horizontal angle of the groove was 17.8° (14° to 23°).
We found that the ideal position of the fluoroscopic beam to obtain
this view was 20° in the horizontal plane and 5° in the sagittal
plane. We then intra-operatively assessed the use of the radial groove
view for detecting protrusion of screws in the EPL groove in 93
fractures that were treated by volar plating. A total of 13 protruding
screws were detected. They were changed to shorter screws and these
patients underwent CT scans of the wrist immediately post-operatively.
There remained one screw that was protruding. These findings suggest
that the use of the radial groove view intra-operatively is a good
method of assessing the possible protrusion of screws into the groove
of EPL when plating a
Aims. Tobacco, in addition to being one of the greatest public health threats facing our world, is believed to have deleterious effects on bone metabolism and especially on bone healing. It has been described in the literature that patients who smoke are approximately twice as likely to develop a nonunion following a non-specific bone fracture. For clavicle
Benefits of early stabilization of femoral shaft
Aims. Acetabular fractures are associated with long-term morbidity. Our prospective cohort study sought to understand the recovery trajectory of this injury over five years. Methods. Eligible patients at a level I trauma centre were recruited into a longitudinal registry of surgical acetabular fractures between June 2004 and August 2019. Patient-reported outcome measures (PROMs), including the 36-Item Short Form Health Survey (SF-36) physical component summary (PCS), were recorded at baseline pre-injury recall and six months, one year, two years, and five years postoperatively. Comparative analyses were performed for elementary and associated
Aims. Paediatric
Aims. The aim of this retrospective study was to assess the incidence of early periprosthetic femoral fracture (PFF) associated with Charnley-Kerboull (CK) femoral components cemented according to the ‘French paradox’ principles through the Hueter anterior approach (HAA) in patients older than 70 years. Methods. From a prospectively collected database, all short CK femoral components implanted consecutively from January 2018 to May 2022 through the HAA in patients older than 70 years were included. Exclusion criteria were age below 70 years, use of cementless femoral component, and approaches other than the HAA. A total of 416 short CK prostheses used by 25 surgeons with various levels of experience were included. All patients had a minimum of one-year follow-up, with a mean of 2.6 years (SD 1.1). The mean age was 77.4 years (70 to 95) and the mean BMI was 25.3 kg/m. 2. (18.4 to 43). Femoral anatomy was classified according to Dorr. The measured parameters included canal flare index, morphological cortical index, canal-calcar ratio, ilium-ischial ratio, and anterior superior iliac spine to greater trochanter (GT) distance. Results. Among the 416 THAs, two PFFs (0.48% (95% confidence interval 0.13 to 1.74)) were observed, including one Vancouver type B2
Aims. The Open-Fracture Patient Evaluation Nationwide (OPEN) study was performed to provide clarity in open
Aims. This study aimed to compare mortality in trochanteric AO/OTA A1 and A2
Malunion is the most common complication of the
distal radius with many modalities of treatment available for such
a problem. The use of bone grafting after an osteotomy is still
recommended by most authors. We hypothesised that bone grafting
is not required; fixing the corrected construct with a volar locked
plate helps maintain the alignment, while metaphyseal defect fills
by itself. Prospectively, we performed the procedure on 30 malunited
dorsally-angulated radii using fixed angle volar locked plates without
bone grafting. At the final follow-up, 22 wrists were available.
Radiological evidence of union, correction of the deformity, clinical
and functional improvement was achieved in all cases. Without the
use of bone grafting, corrective open wedge osteotomy fixed by a
volar locked plate provides a high rate of union and satisfactory
functional outcomes.
Aims. There is a lack of published evidence relating to the rate of nonunion seen in occult scaphoid fractures, diagnosed only after MRI. This study reports the rate of delayed union and nonunion in a cohort of patients with MRI-detected acute scaphoid fractures. Methods. This multicentre cohort study at eight centres in the UK included all patients with an acute scaphoid fracture diagnosed on MRI having presented acutely following wrist trauma with normal radiographs. Data were gathered retrospectively for a minimum of 12 months at each centre. The primary outcome measures were the rate of acute surgery, delayed union, and nonunion. Results. A total of 1,989 patients underwent acute MRI for a suspected scaphoid fracture during the study period, of which 256 patients (12.9%) were diagnosed with a previously occult scaphoid fracture. Of the patients with scaphoid fractures, six underwent early surgical fixation (2.3%) and there was a total of 16 cases of delayed or nonunion (6.3%) in the remaining 250 patients treated with cast immobilization. Of the nine nonunions (3.5%), seven underwent surgery (2.7%), one opted for non-surgical treatment, and one failed to attend follow-up. Of the seven delayed unions (2.7%), one (0.4%) was treated with surgery at two months, one (0.4%) did not attend further follow-up, and the remaining five
Aims. Breast cancer survivors have known risk factors that might influence the results of total hip arthroplasty (THA) or total knee arthroplasty (TKA). This study evaluated clinical outcomes of patients with breast cancer history after primary THA and TKA. Methods. Our total joint registry identified patients with breast cancer history undergoing primary THA (n = 423) and TKA (n = 540). Patients were matched 1:1 based upon age, sex, BMI, procedure (hip or knee), and surgical year to non-breast cancer controls. Mortality, implant survival, and complications were assessed via Kaplan-Meier methods. Clinical outcomes were evaluated via Harris Hip Scores (HHSs) or Knee Society Scores (KSSs). Mean follow-up was six years (2 to 15). Results. Breast cancer patient survival at five years was 92% (95% confidence interval (CI) 89% to 95%) after THA and 94% (95% CI 92% to 97%) after TKA. Breast and non-breast cancer patients had similar five-year implant survival free of any reoperation or revision after THA (p ≥ 0.412) and TKA (p ≥ 0.271). Breast cancer patients demonstrated significantly lower survival free of any complications after THA (91% vs 96%, respectively; hazard ratio = 2 (95% CI 1.1 to 3.4); p = 0.017). Specifically, the rate of intraoperative
Aims. The aim of this study was to perform the first population-based description of the epidemiological and health economic burden of fracture-related infection (FRI). Methods. This is a retrospective cohort study of operatively managed orthopaedic trauma patients from 1 January 2007 to 31 December 2016, performed in Queensland, Australia. Record linkage was used to develop a person-centric, population-based dataset incorporating routinely collected administrative, clinical, and health economic information. The FRI group consisted of patients with International Classification of Disease 10th Revision diagnosis codes for deep infection associated with an implanted device within two years following surgery, while all others were deemed not infected. Demographic and clinical variables, as well as healthcare utilization costs, were compared. Results. There were 111,402 patients operatively managed for orthopaedic trauma, with 2,775 of these (2.5%) complicated by FRI. The development of FRI had a statistically significant association with older age, male sex, residing in rural/remote areas, Aboriginal or Torres Strait Islander background, lower socioeconomic status, road traffic accident, work-related injuries, open
Aims. Triplane ankle
Aims. This study aimed to gather insights from elbow experts using the Delphi method to evaluate the influence of patient characteristics and
Aims. The aim of this study was to report the patterns of symptoms and insufficiency
Aims. The aim of this study was to evaluate the outcome of complex radial head
Aims. The aims of this study were to assess quality of life after hip
Aims. Proximal humeral fractures (PHFs) are common. There is increasing evidence that most of these
Aims. Current levels of hip
Aims. Prior to the availability of vaccines, mortality for hip
Aims. Hip
Aims. This study aimed to describe practice variation in the use of total hip arthroplasty (THA) for older patients with femoral neck
Displaced
Aims. To propose a new method for evaluating paediatric radial neck
Aims. The purpose of this study was to determine the weightbearing practice of operatively managed fragility
Aims. This study explores data quality in operation type and
Hip
Aims. This study aimed to answer the following questions: do 3D-printed models lead to a more accurate recognition of the pattern of complex
Aims. The aim of this study was to examine perioperative blood transfusion practice, and associations with clinical outcomes, in a national cohort of hip
Aims. To determine if patient ethnicity among patients with a hip
Aims. Several different designs of hemiarthroplasty are used to treat intracapsular
Aims. The aim of this study was to investigate the rate of revision for distal femoral arthroplasty (DFA) performed as a primary procedure for native knee
Salter-Harris II
Aims. This study evaluated the effect of treating clinician speciality on management of zone 2 fifth metatarsal
Aims. The aim of this study was to investigate the outcome of periprosthetic
Aims. Pneumatic tourniquets are often used during the surgical treatment of unstable traumatic ankle
Aims. A
Aims. The aim of this study was to report the three-year follow-up for a series of 400 patients with a displaced intracapsular
Aims. Factors associated with high mortality rates in geriatric hip
To assess the feasibility of a randomized controlled trial (RCT) that compares three treatments for acetabular fractures in older patients: surgical fixation, surgical fixation and hip arthroplasty (fix-and-replace), and non-surgical treatment. Patients were recruited from seven UK NHS centres and randomized to a three-arm pilot trial if aged older than 60 years and had a displaced acetabular fracture. Feasibility outcomes included patients’ willingness to participate, clinicians’ capability to recruit, and dropout rates. The primary clinical outcome measure was the EuroQol five-dimension questionnaire (EQ-5D) at six months. Secondary outcomes were Oxford Hip Score, Disability Rating Index, blood loss, and radiological and mobility assessments.Aims
Methods
Aims. Cemented hemiarthroplasty is an effective form of treatment for most patients with an intracapsular
Aims. Surgery is often delayed in patients who sustain a hip
Aims. The risk of mechanical failure of modular revision hip stems is frequently mentioned in the literature, but little is currently known about the actual clinical failure rates of this type of prosthesis. The current retrospective long-term analysis examines the distal and modular failure patterns of the Prevision hip stem from 18 years of clinical use. A design improvement of the modular taper was introduced in 2008, and the data could also be used to compare the original and the current design of the modular connection. Methods. We performed an analysis of the Prevision modular hip stem using the manufacturer’s vigilance database and investigated different mechanical failure patterns of the hip stem from January 2004 to December 2022. Results. Two mechanical failure patterns were identified:
Aims. Hip
Aims. This study estimated trends in incidence of open